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Transition Readiness in Adolescents/Young Adults Approaching Transfer to Adult Care: How are they doing and how can w

Transition Readiness in Adolescents/Young Adults Approaching Transfer to Adult Care: How are they doing and how can we improve?. Wendy N. Gray, Ph.D. Auburn University & Cincinnati Children’s Hospital Medical Center. 12/14/2013. Disclosures. Nothing to Disclose. Background.

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Transition Readiness in Adolescents/Young Adults Approaching Transfer to Adult Care: How are they doing and how can w

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  1. Transition Readiness in Adolescents/Young Adults Approaching Transfer to Adult Care: How are theydoing and how can we improve? Wendy N. Gray, Ph.D. Auburn University & Cincinnati Children’s Hospital Medical Center 12/14/2013

  2. Disclosures Nothing to Disclose

  3. Background • Barriers to transferring patients to adult care exist at many levels • Self-management deficits in older adolescents1 • 79% of adult gastroenterologists report inadequacies in patients transferred from pediatrics2 1. Fishman et al. (2010); 2. Hait et al. (2009)

  4. Transition Task Force • Benchmarks for Transition Readiness: • 90% mastery of transition readiness skills • Mild or quiescent disease • Patient has identified a PCP • Pediatric staff confidence in transition readiness

  5. Purpose • Examine transition readiness skill acquisition in adolescents and young adults • Identify gaps in transition readiness that should be addressed prior to transfer to adult care

  6. Method • Data collected December 2012 - August 2013 • Inclusion criteria: • Patient with Crohn’s or colitis (N = 145, 56.6% male) • Treated at Cincinnati Children’s Hospital Medical Center • Age 16 or older (M = 18.08 ± 1.86 years) • Transition Readiness Assessment Questionnaire (Version 5.0)

  7. Results • Number of patients meeting transition readiness benchmark

  8. Results • Average # of tasks mastered = 9.08 ± 4.83

  9. Results • Gender differences in transition readiness (controlling for age) F(1, 142) = 10.45, p <.01

  10. Results

  11. Results

  12. Conclusion • Few patients on verge of transfer to adult care are meeting our benchmark for transition readiness • Females are demonstrating more readiness than males, regardless of age • Specific deficits exist in self-management and self-advocacy/health care utilization

  13. Implications • Critical to address deficits in adolescence • Deficits observed are all modifiable behaviors amenable to intervention • Routine assessment of transition readiness skills is needed to identify gaps in skills • Guidance needed for patient and parents

  14. Future Directions • CCFA Career Development Award: Development of the Self-Management Transition Enhancement Program (STEP) • Key features: • 3 phase approach to program development • Objective outcome assessment • High level of patient, parent, & clinician engagement

  15. Acknowledgements • Erin Holbrook, MSW, LSW • Pamela Morgan, BSN, RN • Shehzad Saeed, MD • Lee Denson, MD • Kevin Hommel, PhD

  16. Pediatric Care Adult Care Routine assessment, guidance, support Questions? Comments?

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